Levator scapulae

At a glance

English

Levator scapulae

Latin (TA2)

Levator scapulae

System

Muscle

Region

Neck

Side

Paired, left and right

Arises from

The axis (c2), vertebra c3 and vertebra c4

About the levator scapulae

Levator scapulae is a long, slender muscle on the side of the neck towards the back. As its name says, it lifts the shoulder blade. Its upper part lies under sternocleidomastoid and its lower part under trapezius, while its middle part lies bare in the floor of the neck's posterior triangle. Scalenus medius lies in front of it and splenius cervicis behind.

It arises by separate tendinous slips from the transverse processes of the upper four cervical vertebrae, the slips from the atlas and axis being the largest. The slips join into a flat belly that runs down and back, twisting slightly, to end on the medial border of the scapula between its superior angle and the root of the scapular spine. The accessory nerve crosses its surface in the posterior triangle, and the dorsal scapular nerve runs deep to it or through it. The number of slips varies, and extra bands may reach the skull, the first ribs, or neighbouring muscles.

With the neck fixed, the muscle raises the scapula and turns its inferior angle inwards, so the glenoid faces downwards. With the rhomboids and pectoralis minor it rotates the scapula downwards, and it works against the upper trapezius, which rotates it upwards. When the shoulder is fixed it bends the neck to the same side and turns it slightly; acting on both sides it helps steady and extend the neck.

Nerve supply comes from twigs of the C3 and C4 spinal nerves, often with a twig from the dorsal scapular nerve. The main blood supply is the dorsal scapular artery, sometimes helped by the transverse cervical artery. Levator scapulae often becomes tight and tender in people who hold the shoulders raised or the head forward for long periods, giving the common pain at the angle of the neck and the top of the shoulder blade.

Attachments, action and supply

Origin

Transverse processes of C1 to C4 (posterior tubercles of C3 and C4).

Insertion

Medial border of the scapula from the superior angle to the root of the spine.

Action

Elevates the scapula and rotates it downwards; with the shoulder fixed, bends the neck to the same side.

Nerve supply

C3 and C4 spinal nerves, with branches from the dorsal scapular nerve (C5).

Blood supply

Dorsal scapular artery, with help from the transverse cervical artery.